Background and PurposeInformation processing speed is one of the most impaired cognitive functions in multiple sclerosis (MS). There are two tests widely used for evaluating information processing speed: the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). To analyze the relationship between processing speed and the clinical and social support variables of patients with MS.MethodsA group of 47 patients with relapsing-remitting MS was studied, 31 were women and 16, men. Age: 39.04±13.17, years of schooling: 13.00±3.87, Expanded Disability Status Scale (EDSS): 2.78±1.81, and disease evolution: 8.07±6.26. Instruments of measure; processing speed: SDMT, PASAT, clinical variables: EDSS, Fatigue Severity Scale (FSS), Beck's Depression Inventory II (BDI-II), and social support: Medical Outcomes Study Social Support Survey (MOS).ResultsSignificant correlations were found between information processing speed and psychiatric, motor disability and social support variables. The SDMT correlated significantly and negatively with BDI-II, FSS, EDSS, and MOS (p<0.05), whereas the PASAT correlated negatively with FSS and positively with MOS (p<0.05). Information processing speed appeared as the performance predictor of these variables. The SDMT produced significant changes in EDSS (R2=0.343, p=0.000); FSS (R2=0.109, p=0.031); BDI-II (R2=0.124, p=0.018), and MOS (R2=between 0.212 and 0.379, p<0.05).ConclusionsInformation processing speed has influence on the clinical variables and the social support of patients with MS. These aspects are important to bear in mind for therapeutic approach.

BACKGROUND: Multiple sclerosis (MS) is a neurological chronic disease that causes a number of physical, cognitive and emotional symptoms. The identification of these factors will allow mitigating unemployment and improve quality of life of patients. The Buffalo Vocational Monitoring Survey (BVMS) is a tool to characterize Work-Challenged patients. OBJECTIVE: To describe and analyze BVMS data in people with multiple sclerosis (PwMS) from Argentina. To study the association with physical, cognitive and psychiatric morbidity in employed patients, comparing the performance of MS Work-Challenged and MS Work-Stable patients, with and without accommodations. METHODS: 119 MS patients were administered the Argentina adaptation of the BVMS, and completed measures of physical disability, fatigue, depression, cognitive processing speed, memory and verbal fluency. RESULTS: 57.14%of the patients were employed and 19.32%were unemployed, the remaining having roles of housewife, students and disability retirees. Within the employed subgroup, 60.26 %were working as employees and 39.74 %were self-employed. Cognitive and clinical variables differentiate patients with and without negative events and accommodations (p >  0.05). CONCLUSIONS: This Spanish version BVMS is considered a new tool to monitor employment difficulties in Spanish-speaking MS patients. MS Work-Challenged had a higher depression, fatigue and worse performance in cognitive variables.

Background: Scales to assess disability in multiple sclerosis (MS) rarely provides reliable data on the actual global impairment. Upper limbs (UL) dysfunction is usually overlooked, which has a negative impact on the patient's well-being. Objectives: 1) to analyze the association between UL dexterity, lower limbs (LL) speed and the EDSS score. 2) To analyze the difference in UL dexterity between patients with EDSS &lt;5 and ≥5. 3) To study the association that UL dexterity, LL speed and the EDSS score have with both health-related quality of life measurements and depression. Methods: Our sample included 140 adults with MS. They were evaluated using the Nine-Hole Peg Test, the Timed 25-Foot Walk test, the EDSS, the Multiple Sclerosis International Quality of Life questionnaire (MusiQol), and the Beck Depression Inventory. We conducted a thorough descriptive-analytical research using Spearman's correlation, multiple linear regression and structural equation modeling. Results: UL dexterity was more closely related to the EDSS than LL speed (r: 0.43 vs. 0.29, R2: 0.38). UL dexterity was greatest in patients with EDSS &lt;5 (P &lt; .001). Moreover, UL dexterity was negatively associated with EDSS and the MusiQol (rS: between −0.557 and −0.358, P &lt; .05). The correlation that depression has with loss of dexterity in UL was higher than the one it has with LL speed (0.098 vs 0.066, t &gt; 1.96). Conclusions: UL dexterity is associated and global disability, depression, and health-related quality of life. We advocate for the assessment of UL dexterity during MS patients' consultations to adopt a better approach to their functional impairment.

Background: There is no consensus regarding assessment of the brain function functional system (FS) of the Expanded Disability Status Scale (EDSS) in patients with multiple sclerosis (MS). We sought to describe brain function FS assessment criteria used by Argentinian neurologists and, based on the results, propose redefined brain function FS criteria. Methods: A structured survey was conducted of 113 Argentinian neurologists. Considering the survey results, we decided to redefine the brain function FS scoring using the Brief International Cognitive Assessment for MS (BICAMS) battery. For 120 adult patients with MS we calculated the EDSS score without brain function FS (basal EDSS) and compared it with the EDSS score after adding the modified brain function FS (modified EDSS). Results: Of the 93 neurologists analyzed, 14% reported that they did not assess brain function FS, 35% reported that they assessed it through a nonstructured interview, and the remainder used other tools. Significant differences were found in EDSS scores before and after the inclusion of BICAMS (P &lt; .001). Redefining the brain function FS, 15% of patients modified their basal EDSS score, as did 20% of those with a score of 4.0 or less. Conclusions: The survey results show the importance of unifying the brain function FS scoring criteria in calculating the EDSS score. While allowing more consistent brain function FS scoring, including the modified brain function FS led to a change in EDSS score in many patients, particularly in the lower range of EDSS scores. Considering the relevance of the EDSS for monitoring patients with MS and for decision making, it is imperative to further validate the modified brain function FS scoring.